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Individual

MR. JOHNNIE EUGENE JAMES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS, LAT, ATC

Contact information

Practice address
518 W LOCUST ST, DAVENPORT, IA 52803-2829
(563) 333-6062
(563) 333-6239
Mailing address
3820 BELLE AVE, DAVENPORT, IA 52807-1181
(563) 359-3012
(563) 333-6239

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
00622
IA

Other

Enumeration date
01/09/2007
Last updated
07/08/2007
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